Monday, May 25, 2009

Mom, the Final Act

If you wonder why I could not place Mother in assisted living or somewhere less institutional than a nursing home, let me describe her condition to you. She can no longer walk or support herself to any extent. So, she could not help herself to the toilet or shower. As a matter of fact, she cannot really take care of her own toiletry needs, and has someone help her shower (as do most of the residents there). She wears an adult diaper at all times; she is completely incontinent. Her stubbornness causes all of us - myself and the staff - issues here. She will not call them when she soils herself, so she'll sit and "stew" in her waste until they make rounds to check on her. They do this fairly often, because they know this about her and know that it will cause infections. The nurses have kindly fussed at her about it, but as far as I can tell, she hasn't changed. Diapers for adults are prone to the same problems diapers for babies are, only much, much bigger. Enough liquid in them and they will leak. Her clothing, which I bring home to wash, reeks of urine and waste. I brought her laundry home last night to do, and it was so noxious, we had to leave it outside in the garage. When I carried the dark load in, I had to change clothes immediately after. So, wearing latex gloves and an apron, I put the lights in to soak in the mop bucket and left it outside over night. The deer who hang around any time I am outside literally jumped back when I lifted the load out of the car. At this time of year, they are not shy around me, so we think they were reacting to the strong ammonia smell. I have learned how to treat smelly laundry by experimentation. Currently, I have the best success with a combination of baking soda (a lot of it), Oxy Clean and detergent. I soak each load for several hours before I actually wash it. I spray her laundry bin with Febreeze and will often spray the inside of the dryer with it as well. Add the scent of the fabric softener, and that generally makes it bearable. They change her often during the day, so I have to do her wash every few days. Since we are on a septic system, I am less than happy about this, but even if I get her clothing inventory to the level where she could go without me washing for a week or more, the smell would overwhelm the little bathroom in her room. It already does.

The worry when I met with her care team to decide where to house her was really whether she would know when or what to eat or take her medication. Assisted living of course provides nurses to help with medications and standard meal times, but other than that, you are on your own during the day, so she would likely wander off or nod off and skip meals. Here they bring all of that to her.

Then there is her mental capacity. The last really cogent conversation I had with her was in the emergency room the second time she checked into the hospital. I think she was expending great effort to be clear and communicate with me because she was scared she was about to die. Given her condition at the time, it was not an unreasonable fear. But, even then, she wandered off down memory lane, and the conversation turned to her brother Jack, who had died of a heart attack when I was only six (so a long, long time ago). Since then she has days that are better than others, but that's all relative. Add that to the fact that she is notoriously hard of hearing, having a conversation with her is nigh on painful. I visit her every day, but confess that some days I have to grit my teeth to do it. Because she doesn't leave her room often (she is a little freaked out by her co-residents' conditions), doesn't really read anymore or watch the news channels (which is my doing, I'll explain why later), there just is not that much to talk about. And, if I do try to have a conversation with her, I have to yell it. I bring one of my dogs with me most days. Mother loves my husky mix Cheyenne, as do many of the residents. Cheyenne is pretty sensitive to my moods. If I am upset, she will be very quick to comfort me or try and distract me. When I have to raise my voice to speak to Mother, Cheyenne always interprets this as a confrontation. She will paw at me almost to say, "Calm down, calm down. I'm here for you." I have scratches on my arm from where she's tried to intercede when I talk to Mom. One recent conversation I actually was amused by and repeated often right after it happened went like this:

Mom (in discussing the American Idol performances from the night before): Who is that woman who likes all the boys so much?

Me: That's Paula Abdul. She's a pop star from the 80's.

Mom: She doesn't look 80.

Me: No, she's my age. She was a big pop star in the 80's.

Mom: You're not 80.

Me (louder): The 1980's.

Mom: Well, she doesn't look like she's 80.

Me: Sigh.

There are days when she can connect most of the dots, and it really is her hearing that is the biggest problem. She refuses to wear hearing aids, by the way. Other days, she just doesn't seem to be in there any where. I worry that the potent cocktail of medications she is on has something to do with that, and it probably does, but what is the right answer there? You take her off any of those medications, and then the physical ailments worsen. The senior Catch-22.

So, I generally go up there so she can see the dog, check on her and sit around and watch television with her until I can make a gracious excuse for leaving. I always feel a little guilty for fleeing just as soon as I can, but until I can come up with some activity that we can do together, sometimes it's just agony being up there under those circumstances.

By the way, I generally leave her television on the USA network. They have a pretty good line up of interesting syndicated shows that she finds acceptable, but steers her clear of current events. I try, as much as possible, to minimize her contact with news concerning the current administration. While I supported the Obama campaign and am a full fledged member of Texans for Obama, Mother disagrees with that viewpoint. She goes into a nearly Apocalyptic rage when she sees him, and my President is all over the television every day. So, we just avoid the news for the most part. But, that doesn't really help in the brain stimulus department, so I probably contribute to her decline to keep the peace. So sue me.

So, there is my Mother in a nutshell. The final act in a long life. She lead an interesting one, actually. She wasn't particularly well traveled, which was more my father's doing than her own, but she came through the Great Depression, World War II, the Cold War, Vietnam and Watergate. She worked as a nurse and did a stint in a defense materials plant during the war. She was a military wife for 22 years, including during WWII and the Korean conflict, then while Dad was a test pilot during the mid-50's. Then she raised me, for better or worse. She is a proud and strong woman. But, her body and now her mind are not in league any longer with that spirit. Her spirit wants to be living on its own somewhere, but we have to attend to the body, and a nursing facility was the only practical place to do that.

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